COVID-19-Related Worries and Fears Scale (CoV-WoFe)

Abstract

The COVID-19-Related Worries and Fears Scale (CoV-WoFe), developed by Cuadrado et al. (2023), is a concise, 6-item psychological instrument designed to quantitatively assess specific worries and fears related to the pandemic. Its creation involved adapting an initial pool of eight items sourced primarily from the Fear of COVID-19 Scale (FCV-19S) (Ahorsu et al., 2020) and incorporating key elements from the danger and contamination factors of the COVID Stress Scales (CSS) (Taylor et al., 2020).

The CoV-WoFe aims to measure individual concerns regarding contracting the virus, the perceived severity of health implications stemming from COVID-19, and the intensity of fear, often manifesting as uncontrollable physiological symptoms of anxiety. The scale was validated using an online administration format targeting residents in Spain. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) consistently supported a robust bifactorial structure, which was further confirmed through rigorous testing of measurement invariance, reliability, and validity across different populations.

Keywords

COVID-19-Related Fears, COVID-19-Related Worries, Health Consequences, Physiological Symptoms, Psychometric Scale, Measurement Invariance

Authors

Cuadrado, Esther, Arenas, Alicia, Moyano, Manuel, La Gamma, Martina

Purpose

The primary objective of the COVID-19-Related Worries and Fears Scale (CoV-WoFe) is to provide a comprehensive and psychometrically sound assessment of the psychological distress experienced by individuals specifically in relation to the COVID-19 pandemic. This includes capturing the emotional and cognitive responses to the perceived threat of the virus.

Specifically, the scale is designed to quantify three main areas of concern: the fear of personal infection, the degree of worry regarding the potential health consequences (both for oneself and loved ones), and the manifestation of intense, often uncontrolled, physiological and behavioral symptoms associated with fear and anxiety concerning the virus. The concise, bifactorial nature of the scale makes it an efficient tool for research and clinical screening during public health crises.

Construct

The CoV-WoFe measures a bidimensional psychological construct related to the threat posed by the COVID-19 pandemic, encompassing both cognitive/evaluative components (worry) and affective/physiological components (fear). These two distinct but related factors are categorized as: Worry about the health consequences of COVID-19 (CoV-Wo) and Fear of COVID-19 (CoV-Fe).

The Worry about the health consequences of COVID-19 (CoV-Wo) factor focuses on cognitive concerns, such as the perceived risk of contracting the virus and the effectiveness of protective measures. The Fear of COVID-19 (CoV-Fe) factor captures the affective response, particularly the intensity of emotional and physiological arousal (e.g., rapid heartbeat, sleep disruption) triggered by thoughts or exposure to information about the virus. This dual structure provides a nuanced understanding of pandemic-related distress.

Validity

The CoV-WoFe demonstrates strong construct validity, as evidenced by its predictable and consistent relationships within the broader nomological network of COVID-19 psychological response research. The scale scores correlate logically with several key variables, including direct personal experience with COVID-19, the endorsement of personal values emphasizing security, the stated intention to engage in protective health behaviors, actual protective behaviors adopted, and overall levels of anxiety. This pattern of correlations supports the external validity of the instrument.

Further evidence for construct validity was established by observing the serial mediating role of the two core CoV-WoFe dimensions (CoV-Wo and CoV-Fe). These dimensions were found to mediate the relationship between security values and the adoption of protective behaviors against COVID-19, as well as the relationship with general anxiety levels. Additionally, the presence of expected gender differences in CoV-WoFe scores further reinforced the scale’s ability to accurately measure the intended construct across demographic groups.

Reliability

The CoV-WoFe exhibits a high degree of internal consistency, confirming that its items reliably measure the underlying constructs. The reliability coefficient for the overall CoV-WoFe scale was reported as high, with Cronbach’s alpha ($alpha$) = .86.

The two specific factors also demonstrated robust reliability coefficients: the Worry about the health consequences of COVID-19 (CoV-Wo) factor achieved an alpha of $alpha$ = .86, and the Fear of COVID-19 (CoV-Fe) factor showed $alpha$ = 0.85. Even after the necessary removal of two initial items (items 2 and 3) during the development phase, the scale’s internal consistency remained high, with the overall CoV-WoFe maintaining an alpha of $alpha$ = 0.85, and the CoV-Wo factor retaining $alpha$ = 0.81. Data concerning other forms of reliability, such as test-retest reliability, were not provided in the source documentation.

Factor Analysis

The validation process of the CoV-WoFe involved rigorous statistical testing through both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), confirming its bi-factorial structure.

Exploratory Factor Analysis (EFA): An initial EFA led to the elimination of two items (items 2 and 3) due to their poor correlation and weak loadings with the items designed for the second expected factor. Following this refinement, the resulting EFA successfully revealed the two anticipated factors (CoV-Wo and CoV-Fe) with a balanced structure, collectively accounting for 77.99% of the total variance in the scores.

Confirmatory Factor Analysis (CFA): The streamlined, bidimensional model identified through the EFA was subsequently tested using CFA across two distinct samples. The CFA results provided strong evidence of good to excellent model fit indices in both samples, supporting the proposed structure:

• Sample 1: $chi^2$(df= 6) = 8.240, p = 0.221; RMSEA (95% CI) = .035 [.001, .088]; CFI = 0.998; GFI = 0.994; TLI = 0.994.

• Sample 2: $chi^2$(df= 6) = 15.014, p = .020; RMSEA (95% CI) = .068 [.025, .112]; CFI = 0.991; GFI = 0.986; TLI = 0.977.

Measurement Invariance: A multigroup CFA was performed to evaluate the scale’s stability across genders. The findings confirmed both metric and scalar invariance between men and women. This crucial finding ensures that the bi-factorial structure of the CoV-WoFe is invariant across gender, validating its use for reliable comparisons between male and female populations.

Instrument

Test Type: Original Instrument/Inventory/Questionnaire

Format: The CoV-WoFe is a 6-item scale utilizing a seven-point Likert scale response format, ranging from ‘1’ (“Strongly disagree”) to ‘7’ (“Totally agree”). The administration method employed during validation was electronic (online).

Language Available: Spanish. The scale was originally translated and adapted from English items into Spanish.

Population Group: Human; Male; Female

Age Group: Adulthood (18 years & older), including Young Adulthood (18-29 yrs), Thirties (30-39 yrs), Middle Age (40-64 yrs), Aged (65 yrs & older), and Very Old (85 yrs & older).

Population Details: The validation study population consisted of residents in Spain.

Test Methodology: The development and validation process was comprehensive, involving Test Validity, Construct Validity, Test Reliability, Internal Consistency analysis, Factor Analysis (including both Confirmatory Factor Analysis and Exploratory Factor Analysis), and Measurement Invariance assessment.

Keywords

COVID-19 Perceptions, Psychological Measurement, Bi-factorial Model, Internal Consistency, Construct Validity

Authors

Author ORCID Identifier: No data is Available for most authors.

Affiliation Email addresses: [email protected] (Esther Cuadrado)

Correspondence Address: [email protected]

Affiliations:

• Esther Cuadrado: Department of Psychology, University of Cordoba

• Alicia Arenas: Maimonides Biomedical Research Institute of Cordoba (IMIBIC)

• Manuel Moyano: Department of Psychology, University of Cordoba

• Martina La Gamma: Department of Psychology, University of Florence

Permissions & Fee and Test Year

Permissions: May use for Research/Teaching.

Commercial Use: No

Fee: No

Test Year: 2023

Web Site: creativecommons.org/licenses/by/4.0/deed.en

Reference’s

Cuadrado, E., Arenas, A., Moyano, M., & La Gamma, M. (2023). Development and validation of the COVID-19 Worries and Fears Scale. International Journal of Public Health, 67, Article 1604600. https://doi.org/10.3389/ijph.2022.1604600

Items of the COVID-19-Related Worries and Fears Scale (CoV-WoFe)

The final measure consists of 6 items, although 8 items were initially tested. The items of the CoV-WoFe are available at 2023-41304-001, Supplemental Material.

Factors and Subscales:

• Worry about the health consequences of COVID-19 (CoV-Wo)

• Fear of COVID-19 (CoV-Fe)

Note: CSS = COVID Stress Scale; FC-19S = Fear of COVID-19S

*Item eliminated from the final scale (Items 2 and 3 were eliminated, resulting in the final 6-item scale composed of items 1, 4, 5, 6, 7, and 8 from the original pool).